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    1. MET or NRAS amplification is an acquired resistance mechanism to the third-generation EGFR inhibitor naquotinib

      [Paper-level Aggregated] PMCID: PMC5792548

      Evidence Type(s): Oncogenic, Predictive, Functional

      Justification: Oncogenic: The presence of the EGFR T790M mutation is associated with resistance to EGFR TKIs, indicating its role in tumorigenesis and treatment resistance in non-small cell lung cancer. Predictive: The EGFR T790M mutation is used to predict the efficacy of third-generation EGFR TKIs like osimertinib, as it is a known biomarker for response to this treatment. Functional: The study investigates the functional consequences of various mutations, including T790M and C797S, on the resistance mechanisms of lung cancer cells to EGFR TKIs, demonstrating their impact on cell proliferation and signaling pathways.

      Gene→Variant (gene-first): EGFR(1956):19del EGFR(1956):T790M EGFR(1956):C797S

      Genes: EGFR(1956)

      Variants: 19del T790M C797S

    2. Finally, we tested the effects of the combination therapies on cell proliferation in osimertinib-resistant cell lines. Similar to RPC-9/NaqR cells, the osimertinib-resistant cell lines were derived from RPC-9 cells, desi

      [Paragraph-level] PMCID: PMC5792548 Section: RESULTS PassageIndex: 14

      Evidence Type(s): Predictive, Oncogenic

      Justification: Predictive: The passage discusses the effects of combination therapies on cell proliferation in osimertinib-resistant cell lines, indicating a relationship between the presence of the T790M mutation and the response to therapy, specifically mentioning osimertinib and naquotinib. Oncogenic: The T790M mutation is maintained in the osimertinib-resistant RPC-9/OsiR cells, suggesting its role in tumor development or progression, particularly in the context of resistance to therapy.

      Gene→Variant (gene-first): 1956:C797S 1956:T790M

      Genes: 1956

      Variants: C797S T790M

    3. Next we investigated RPC-9/NaqR cells, which were derived from gefitinib-resistant lung adenocarcinoma cell lines (RPC-9 cells harboring the EGFR exon 19del and T790M mutations). Exposure to naquotinib inhibited the phos

      [Paragraph-level] PMCID: PMC5792548 Section: RESULTS PassageIndex: 10

      Evidence Type(s): Predictive, Oncogenic

      Justification: Predictive: The passage discusses gefitinib-resistant lung adenocarcinoma cell lines harboring the EGFR exon 19del and T790M mutations, indicating a correlation with resistance to therapy, specifically gefitinib. Oncogenic: The mention of the EGFR exon 19del and T790M mutations in the context of gefitinib resistance suggests that these somatic variants contribute to tumor development or progression in lung adenocarcinoma.

      Gene→Variant (gene-first): 1956:19del 1956:T790M

      Genes: 1956

      Variants: 19del T790M

    4. To further examine the role of MET in EGFR-TKI-naive cancer cells, we developed another resistant cell line from EGFR-TKI-naive lung cancer cells, HCC827, which harbor the EGFR exon 19del. The resistant cell line, design

      [Paragraph-level] PMCID: PMC5792548 Section: RESULTS PassageIndex: 8

      Evidence Type(s): Oncogenic, Predictive

      Justification: Oncogenic: The passage discusses the role of the EGFR exon 19del variant in the development of a resistant cell line, indicating that this somatic variant contributes to tumor progression and resistance mechanisms in lung cancer cells. Predictive: The passage mentions that the combination of EGFR-TKIs and MET inhibitors showed an excellent inhibitory effect on cell proliferation in the resistant cell line, suggesting a correlation between the variant and response to therapy.

      Gene→Variant (gene-first): 1956:19del

      Genes: 1956

      Variants: 19del

    5. Next, we assessed the effects of several generations of EGFR-TKIs in these naquotinib-resistant cell lines. The resistant cell lines exhibited 52- to 157-fold resistance to naquotinib compared with each parental cell lin

      [Paragraph-level] PMCID: PMC5792548 Section: RESULTS PassageIndex: 4

      Evidence Type(s): Predictive, Oncogenic

      Justification: Predictive: The passage discusses the acquired EGFR C797S mutation in the context of resistance to osimertinib, indicating that this variant correlates with resistance to a specific therapy. Oncogenic: The C797S mutation is described as contributing to resistance in cell lines, suggesting its role in tumor progression or development in the context of EGFR-TKI treatment.

      Gene→Variant (gene-first): 1956:C797S

      Genes: 1956

      Variants: C797S

    6. First, to explore the mechanism of resistance to naquotinib, we established naquotinib-resistant lung cancer cells using a cell line-based model. The following cell lines were examined: 1. EGFR-TKI-naive PC-9 cells harbo

      [Paragraph-level] PMCID: PMC5792548 Section: RESULTS PassageIndex: 3

      Evidence Type(s): Predictive, Oncogenic

      Justification: Predictive: The passage discusses the establishment of naquotinib-resistant lung cancer cells and mentions the effectiveness of naquotinib in inhibiting cell proliferation, indicating a correlation between the variants (19del and T790M) and resistance to therapy. Oncogenic: The presence of the T790M mutation in acquired gefitinib-resistant cells suggests that it contributes to tumor development or progression, as it is associated with resistance mechanisms in lung cancer.

      Gene→Variant (gene-first): 1956:19del 1956:T790M

      Genes: 1956

      Variants: 19del T790M

    7. As a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), osimeritnib is the standard treatment for patients with non-small cell lung cancer harboring the EGFR T790M mutation; however

      [Paragraph-level] PMCID: PMC5792548 Section: ABSTRACT PassageIndex: 1

      Evidence Type(s): Predictive, Diagnostic, Oncogenic

      Justification: Predictive: The passage discusses the EGFR T790M mutation in the context of treatment response to osimeritinib and the development of resistance, indicating a correlation with therapy outcomes. Diagnostic: The passage states that the EGFR T790M mutation is used to identify patients with non-small cell lung cancer who are eligible for treatment with osimeritinib, thus classifying it as a diagnostic marker. Oncogenic: The EGFR T790M mutation is described as contributing to resistance in lung cancer, which implies its role in tumor progression and development.

      Gene→Variant (gene-first): 1956:T790M

      Genes: 1956

      Variants: T790M

    8. Finally, we tested the effects of the combination therapies on cell proliferation in osimertinib-resistant cell lines. Similar to RPC-9/NaqR cells, the osimertinib-resistant cell lines were derived from RPC-9 cells, desi

      [Paragraph-level] PMCID: PMC5792548 Section: RESULTS PassageIndex: 14

      Evidence Type(s): Predictive, Oncogenic

      Justification: Predictive: The passage discusses the effects of combination therapies on cell proliferation in osimertinib-resistant cell lines, indicating a relationship between the presence of the T790M mutation and the response to therapy, specifically mentioning osimertinib and naquotinib. Oncogenic: The T790M mutation is maintained in the osimertinib-resistant RPC-9/OsiR cells, suggesting its role in tumor development or progression, particularly in the context of resistance to therapy.

      Gene→Variant (gene-first): 1956:C797S 1956:T790M

      Genes: 1956

      Variants: C797S T790M

    9. Next we investigated RPC-9/NaqR cells, which were derived from gefitinib-resistant lung adenocarcinoma cell lines (RPC-9 cells harboring the EGFR exon 19del and T790M mutations). Exposure to naquotinib inhibited the phos

      [Paragraph-level] PMCID: PMC5792548 Section: RESULTS PassageIndex: 10

      Evidence Type(s): Predictive, Oncogenic

      Justification: Predictive: The passage discusses gefitinib-resistant lung adenocarcinoma cell lines harboring the EGFR exon 19del and T790M mutations, indicating a correlation with resistance to therapy, specifically gefitinib. Oncogenic: The mention of the EGFR exon 19del and T790M mutations in the context of gefitinib resistance suggests that these somatic variants contribute to tumor development or progression in lung adenocarcinoma.

      Gene→Variant (gene-first): 1956:19del 1956:T790M

      Genes: 1956

      Variants: 19del T790M

    10. To further examine the role of MET in EGFR-TKI-naive cancer cells, we developed another resistant cell line from EGFR-TKI-naive lung cancer cells, HCC827, which harbor the EGFR exon 19del. The resistant cell line, design

      [Paragraph-level] PMCID: PMC5792548 Section: RESULTS PassageIndex: 8

      Evidence Type(s): Oncogenic, Predictive

      Justification: Oncogenic: The passage discusses the role of the EGFR exon 19del variant in the development of a resistant cell line, indicating that this somatic variant contributes to tumor progression and resistance mechanisms in lung cancer cells. Predictive: The passage mentions that the combination of EGFR-TKIs and MET inhibitors showed an excellent inhibitory effect on cell proliferation in the resistant cell line, suggesting a correlation between the variant and response to therapy.

      Gene→Variant (gene-first): 1956:19del

      Genes: 1956

      Variants: 19del

    11. Next, we assessed the effects of several generations of EGFR-TKIs in these naquotinib-resistant cell lines. The resistant cell lines exhibited 52- to 157-fold resistance to naquotinib compared with each parental cell lin

      [Paragraph-level] PMCID: PMC5792548 Section: RESULTS PassageIndex: 4

      Evidence Type(s): Predictive, Oncogenic

      Justification: Predictive: The passage discusses the acquired EGFR C797S mutation in the context of resistance to osimertinib, indicating that this variant correlates with resistance to a specific therapy. Oncogenic: The C797S mutation is described as contributing to resistance in cell lines, suggesting its role in tumor progression or development in the context of EGFR-TKI treatment.

      Gene→Variant (gene-first): 1956:C797S

      Genes: 1956

      Variants: C797S

    12. First, to explore the mechanism of resistance to naquotinib, we established naquotinib-resistant lung cancer cells using a cell line-based model. The following cell lines were examined: 1. EGFR-TKI-naive PC-9 cells harbo

      [Paragraph-level] PMCID: PMC5792548 Section: RESULTS PassageIndex: 3

      Evidence Type(s): Predictive, Oncogenic

      Justification: Predictive: The passage discusses the establishment of naquotinib-resistant lung cancer cells and mentions the effectiveness of naquotinib in inhibiting cell proliferation, indicating a correlation between the variants (19del and T790M) and resistance to therapy. Oncogenic: The presence of the T790M mutation in acquired gefitinib-resistant cells suggests that it contributes to tumor development or progression, as it is associated with resistance mechanisms in lung cancer.

      Gene→Variant (gene-first): 1956:19del 1956:T790M

      Genes: 1956

      Variants: 19del T790M

    13. As a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), osimeritnib is the standard treatment for patients with non-small cell lung cancer harboring the EGFR T790M mutation; however

      [Paragraph-level] PMCID: PMC5792548 Section: ABSTRACT PassageIndex: 1

      Evidence Type(s): Predictive, Diagnostic, Oncogenic

      Justification: Predictive: The passage discusses the EGFR T790M mutation in the context of treatment response to osimeritinib and the development of resistance, indicating a correlation with therapy outcomes. Diagnostic: The passage states that the EGFR T790M mutation is used to identify patients with non-small cell lung cancer who are eligible for treatment with osimeritinib, thus classifying it as a diagnostic marker. Oncogenic: The EGFR T790M mutation is described as contributing to resistance in lung cancer, which implies its role in tumor progression and development.

      Gene→Variant (gene-first): 1956:T790M

      Genes: 1956

      Variants: T790M